We have explored the relative merits of a new form of mechanical ventilation (MV) - Intratracheal Pulmonary Ventilation (ITPV), and compared its performance with conventional continuous positive pressure ventilation (CPPV). Studies were performed in anesthetized, paralyzed sheep in which acute respiratory failure (ARF) had been induced from effects of MV at high peak inspiratory pressures (PIP). Under identical conditions, ITPV provided substantially enhanced CO2 removal, hence allowed the use of lower tidal volumes and (in effect) the use of normal PIP. Such treatment led to full recovery of lung function. More importantly, such initial lung management, by inference, would have prevented the initial onset of ARF form effects of CPPV at high PIP in the first place. We have further improved on the design of conventional endotracheal tubes (ETT). Those ETTs were made of wire reinforced polyurethane with a wall thickness about 0.20 mm. They are exceptionally supple, and kink-proof. We have now shaped the glottic portion of the ETT to conform better to the geometry of the glottis, i.e. we shaped it into an oval/egg shaped form. The wire reinforcement is now made of nickel titanium superelastic alloy, making the ETTs truly crush proof. The glottic portion of the ETTs was fitted with numerous ultra-thin pliable discs ("gills") that served the purpose of providing a seal with the laryngeal/tracheal structures. In studies in sheep and in rabbits, there was minimal/no air leak. There were minimal/no lesions on laryngeal/tracheal structures following 24 h of intubation and MV.